Games for health: 14 trick questions for Ben Sawyer

Ben Sawyer is the co-founder of both the Serious Games Initiative (2002) and the Games for Health Project (2004). He is one of the leading experts on the use of game technologies, talent, and design techniques for purposes beyond entertainment. He answered 14 questions by e-mail ahead of his presentation to the IFRC Global Health Team.

1. What is your favorite game?

I used to reference an old RPG (role playing game) called Ultima IV. But, in reality, it’s Minecraft. Just such a great achievement and fun to play.

2. What is the worst “serious game” you have ever played?

Most of them.

3. What is a game, anyway?

A game by definition is a system, defined by rules, where people engage in defined competition to achieve a quantifiable outcome either against an opponent or the system itself. There are many dictionary-style definitions. In reality, a game is a mediated experience. Whether something is a game is based on the perception of the user and their reaction to interacting with the game. Increasingly such perceptions are defined by people’s experience and expectations of the games they play or have played in life. Thus it’s possible to have many things that are, by definition, a game, but by perception of players are not worthy of that phrase.

4. What is the difference between games and gamification?

The former is about creating a fully cognitive experience with a more encompassing model of engagement and interaction, and the other is about trying to short circuit the experience and use just a few things in hopes that creating a “game” or an experience that instills some of the core ideas of what a game is by definition will generate a bump in engagement. They’re not the same thing. Often, gamification devolves to just creating competitive experiences based on some sort of point-scoring model that is at-best glorified industrial psychology and not necessarily a great, giant outcome of innovation or game design.

5. Why use games for serious health work?

There are a variety of reasons, but the biggest is that games hold strong promise to instantiate behavior change through a variety of media, simulation, and cognitive effects.

6. If you don’t play games, can you still design one?

Everyone can design games, some people do it pretty well, but ideally it’s professionals working with vision holders and experts that generate great games.

7. Can games motivate learners to change behavior?

Yes, and we have proof of that in research. That said, it’s a lot of work, and there are different approaches, and ideally they need to be part of more comprehensive programs.

8. Can you prove that serious games can affect health outcomes? What does the evidence say?

The evidence so far says that games which are carefully constructed by good teams, using clear theory, and building a clear model of what drives behavior change have a chance to do it. That means most things don’t, because they don’t follow the careful approaches needed to ensure the best chance for success.

9. What do you need to understand to successfully launch a game that improves health?

First, you need to understand what’s possible to do, and what might be worth risking to do. In terms of launching, the biggest issue is understanding how you’re going to reach and support your users such that they see the utility of what they’ll do such that it is an equal attractor alongside their enjoyment of the game itself.

10. What are the most common myths and misconceptions about “serious games”?

That games have to be “fun” to be effective, that games have to be more fun than the best entertainment only games, and that just because something is a game by definition it inherently provides the best outcomes we associate with our favorite games. And that this is only and predominantly about engagement and motivation versus any other factors.

11. Who funds health games and why?

So far, it has been government and foundation funds looking to find new breakthroughs in health and healthcare, so mostly research into the art of the possible. Beyond that, it has been private groups seeking to create new products, or new engagement models, something that generates new paths to new services.

12. HTML5 or app? iOS or Android? Should health folks care about the choice of technology?

They should care about having a strategy that makes them able to run on all the leading platforms for the least amount of work possible. That can mean many different approaches, but in general it should not be a process that locks you in. There are at least three great ways to achieve cross platform responsive design – and they each have pros and cons.

13. What is the best game studio for serious games?

The best studio is situational. The best approach is to have game designers and producers who are agnostic as to what to make, how, and for how much, help you define your game without any conflict of interest in who or how it’s precisely built. And then, based on the qualified idea of what you want and should make, to find the best available and affordable developer that fits your culture, needs, and especially the specifics of what you should make. Hire an architect before you hire the person to build your house – games are no different.

14. What’s the best way to demonstrate the power of a game for health?